急性中毒患儿血清心肌酶水平变化及意义

Changes of serum myocardial enzyme level and its clinical significance in children with acute intoxication

目的 探讨急性中毒患儿血清心肌酶水平的变化及临床意义。方法 应用全自动生化分析仪测定 3 2例急性中毒患儿 (中毒组 )入院时、入院第 7天 ( 2 3例 )血清肌酸激酶 (CK)、肌酸激酶心型同工酶 (CK -MB)、乳酸脱氢酶 (LDH)、α-羟丁酸脱氢酶 (α-HBDH)和天门冬氨基酸转移酶 (AST)水平 ,并与 3 0例体检正常儿童 (对照组 )进行对照分析。结果 中毒组入院时CK、CK -MB、LDH、α-HBDH和AST分别为 ( 10 76 478± 73 1 3 2 1)U/L、 ( 5 0 667± 3 6 44 9)U/L、 ( 3 0 1 2 3 3± 12 8 983 )U/L、 ( 2 3 7 10 0± 85 44 7)U/L和 ( 115 83 2± 46 672 )U/L ,对照组则分别为 ( 161 85 7± 46 766)U/L、 ( 14 82 1± 8 85 7)U/L、 ( 2 3 2 786± 5 9 146)U/L、 ( 173 82 0± 2 5 811)U/L和 ( 40 64 3± 17 92 0 )U/L ,中毒组LDH与对照组间比较差异有显著性意义 (P <0 0 1) ,CK、CK -MB、α -HB DH和AST中毒组与对照组间比较差异有显著性意义 (P <0 0 0 1) ;入院第 7天中毒组复查CK、CK -MB和AST降至正常水平 ,但LDH和α-HBDH分别为 ( 2 71 43 6± 71 2 2 4)U/L和 ( 2 12 946± 88 12 9)U/L ,与对照组间差异有显著性意义 (P <0 0 5 )。结论 急性中毒患儿早期即有心肌损害 ,即使经治疗后中毒症状缓解 ,?

Objective To explore the change of serum myocardial enzyme level and its clinical significance.Methods 32 cases with acute intoxication (intoxication group) were tested of the level of serum creatine kinase (CK),creatine kinase and myocardial myoglobin isoenzyme(CK-MB),lactate dehydrogenase(LDH),α-hydrooxybutryrate dehydrogenase (α-HBDH) and aspartate transaminase(AST) by using automatic biochemistry analyzer when they were on admission and on the seventh day of admission(23 cases).The results were contrasted with 30 healthy children(contrast group) and analyzed.Results The level of CK,CK-MB,LDH,α-HBDH and AST in intoxication group on admission were(1076478±731321)U/L,(50667±36449)U/L,(301233±128983)U/L,(237100±85447)U/L and (115832±46672)U/L respectively.In the contrasted group,they were (161857±46766)U/L,(14821±8857)U/L,(232786±59146)U/L,(173820±25811)U/L and (40643±7920)U/L respectively.LDH in the intoxication group were higher than that in the contrasted group(P<001).CK,CK-MB,LDH,α-HBDH and AST in the former group were significantly higher than those in the latter group(P<0001).On the seventh day of admission,CK,CK-MB and AST reduced to the normal level.But LDH and α-HBDH remained higher than the contrasted group(P<005) with the result of (271436±71224)U/L and (212946±88129)U/L respectively.Conclusion Children with acute intoxication in the early stage will have myocardial injury as a whole.Even if the signs of intoxication could be released after treatment,myocardial injury will not recover.Examination of myocardial enzyme level has great value in diagnosing children of acute intoxication complicated with myocardial injury.